Elevated platelet activating factor in the tracheal aspirate at birth and signs of intra-uterine inflammation in infants with neonatal pulmonary emphysema |
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Authors: | N Koyama Y Ogawa |
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Institution: | (1) Department of Paediatrics, Saitama Medical Centre, Saitama Medical School, 1981 Tujido, Kamota, Kawagoe, Saitama 350-8550, Japan, JP |
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Abstract: | To investigate the pathophysiology of the neonatal pulmonary emphysema, we assayed platelet activating factor (PAF) in the
tracheal aspirates of the low birth weight infants. A total of 29 neonates (birth weight <1750 g) who required mechanical
ventilation were enrolled. Tracheal aspirates were obtained within 48 h and blood samples collected within 24 h of life. PAF
was assayed on the basis of its ability to cause aggregation of washed rabbit platelets. PAF was significantly elevated in
four infants who showed pulmonary emphysema within the 1st week of life (median 24 pg/g lipid phosphorus, range 9.9–200) compared
with those detected in the other three groups of infants; infants with respiratory distress syndrome (RDS) in whom chronic
lung disease (CLD) did not develop (median 1.8 pg/g lipid phosphorus, range 0–30; P < 0.05), infants without RDS nor CLD (median 0.64 pg/g lipid phosphorus, range 0–14; P < 0.05) and infants with other types of CLD (median 1.1 pg/g lipid phosphorus, range 0–1.8; P < 0.01). The four infants who developed pulmonary emphysema within the 1st week of life, had significantly elevated serum
IgM and neutrophilia at birth. The increased amount of PAF in the tracheal aspirates shows the presence of inflammation in
the lung at birth. The elevated serum IgM level and neutrophilia indicate that the inflammation begins in utero.
Conclusion Our data suggest that neonatal pulmonary emphysema is caused by intra-uterine inflammation increasing platelet activating
factor in the lungs. Platelet activating factor may play a role in aggravating the process of pulmonary emphysema.
Received: 20 July 1998 / Accepted: 14 February 1999 |
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Keywords: | Platelet activating factor Chronic lung disease Broncho-alveolar lavage fluid Pulmonary emphysema Immunoglobulin M |
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